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56 Cards in this Set

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What is Chadwick's sign?
Discoloration of the walls of the vagina and cervix; a presumptive sign of pregnancy
diagnosing pregnancy; discoloration
What is Chloasma?
a tan or dark facial skin discoloration; presumptive sign in the diagnosis of pregnancy
a type of skin change...
What is Hegar's sign?
Softening of the cervix; a PROBABLE sign of pregnancy
has to do with the cervix
List 4 POSITIVE signs in the diagnosis of pregnancy?
1. Auscultation of the fetal heart; 2. Perception of movement by an experienced examiner; 3. Demonstration of a fetus by ultrasound; 4. Positive pregnancy test
3 have to do with the fetus; one is biochemical
betaHCG is produced by...?
the placenta
The serum of a pregnant woman will be positive for beta-HCG how many days post-conception?
9 days
early on in first trimester
plasma levels of beta-HCG double every 48 hours until it hits a maximum at ___ to ___ weeks gestation?
8 to 10 weeks gestation
still in first trimester
What is Naegle's rule?
- LMP + 9 calendar months + 7 days;
- LMP - 3 calendar months + 7 days

(based on 28-30 day menstrual cycle; adjust as per cycle length)
A way to determine Estimated Date of Conception...
How often does beta-HCG double?
After 9 days post-conception when it first appears, it proceeds to double once every 48 hours to a maximum at 8-10 weeks gestation, when it plateaus.
It only keeps doubling for a certain period in the first trimester...
If beta-HCG is higher than expected consider...(2 things)?
twins or a molar pregnancy
In preconception vs. conception, how often and at what dose should someone be taking folic acid?
0.4 mg daily preconception and in the first three months after conception
Which B-vitamin is folic acid?
Water soluble form (along with folate) of vitamin B9.
In which cases should a woman take 5mg of folic acid?
If has diabetes, epilepsy, or a family history of Neural Tube Defects (NTD) or previous child with NTD
2 major conditions and NTD
Cervical cerclage is also known as (another name for this)?
tracheloplasty
_____plasty
Presumptive signs of pregnancy?
1. amenorrhea,
2. Chadwick's,
3. striae,
4. Chloasma,
5. fetal movments (perception of)
6. breast changes
7. Subjective feelings (fatigue, urinary frequency, N/V (nausea/vomiting) , constipation, dyspepsia
2 changes vagina, 3 abdomen, 1 breast, 1 general
The 'sign' that indicates softening of the cervix is..
Hegar's sign
H...'s sign
How is a fetus demonstrated by ultrasound at 5 week's time?
intrauterine sac visible by 5 weeks amenorrhea
sac
How is a fetus demonstrated by ultrasound at 6 week's time?
fetal pole
thickening of the margin of the yolk sac
How is a fetus demonstrated by ultrasound between 7 to 8 week's time?
fetal cardiac activity
activity of an organ...
In the targeted review covering preconception issues, which 7 categories should you cover?
1. Age
2. BMI
3. Immunization status
4. Genetic/Familial/Ethnic risk
5. Medical Illnesses
6. Obstetric Hx
7. Lifestyle Issues
apart from age, medical illnesses, lifestyle issues, 4 others that are more targeted...

In the targeted review of preconception issues, you're particularly interested in knowing the immunization status for which two diseases?
Rubella and Varicella Zoster
R... and V...
Which of the following meds is not safe during pregnancy: ACE inhibitors, labetolol, methyldopa?
ACE inhibitors!
If you want to achieve anticoagulation preconception or during preganancy, you should consider ___ instead of ____ due to the chance of a certain type of embryopathy?
Consider Heparin or Low Molecular Weight Heparin instead of Coumadin, which can lead to warfarin embryopathy
use of this drug during pregnancy will lead to "warfarin embryopathy"
Two medications you may use for the treatment of pre-eclamptic toxaemia (PET) are...?
ASA or Heparin
A... or H...
average length of pregnancy is...(days/lunar months/weeks from LMP)?
280 days, 10 lunar months, or 40 weeks from LMP (38 weeks from ovulation/conception)
U/S is accurate within ___ week(s) in the first trimester, ___ week(s) in the second trimester and ___ week(s) in the third trimester?
1 week in first trimester, 2 in second, and 3 in third
follows pattern...
What is the position of the fundus of the uterus at 12 weeks, 16 weeks, 20 weeks, term?
at the symphysis: 12 weeks
between symphysis and umbilicus: 16 weeks
at umbilicus: 20 weeks
at xyphoid: term
When is the position of the fundus of the uterus at (in weeks) at the xyphoid, umbilicus, inbetween the umbilicus and symphysis, and at the symphysis?
@ 12 weeks: symphysis
@ 16 weeks: between umbilicus and symphysis
@ 20 weeks: umbilicus
@ Term: Xyphoid
Give 4 examples of maternal issues that would identify a pregnancy as being "at-risk"?
1. Pre-eclampsia (pregnancy induced HTN without proteinuria or with proteinuria
2. Gestational diabetes
3. ICP: intrahepatic cholestasis of pregnancy
4. PUPPPS: Pruritic Urticarial Plaques and Papules of Pregnancy
related to heart, pancreas, liver, skin
Give 5 examples of 'fetal issues' that would identify a pregnancy as being at risk?
1. growth restriction/macrosomia
2. anomalies (chromosomal/structural)
3. cardiac arrythmias
4. hydrops (immune and non-immune)
5. malpresentation
List 7 placental/obstetrical issues that would indicate a pregnancy as being at risk?
1. short cervix
2. uterine irritability / preterm labor
3. antepartum hemorrhage
4. preterm prelabor rupture of the membranes
5. abnormal placentation
6. polyhydramnios/oligohydramnios
7. post term pregnancy
how is fetal growth assessed each visit during prenatal assessments?
indirectly through symphysis fundal height
T/F: Accuracy of U/S estimation of growth increases in late pregnancy and with larger fetuses?
FALSE! U/S estimation of fetal growth actually DECREASES in late pregnancy and with larger fetuses
PET (pre-eclamptic toxaemia) is most worrisome for a pregnant woman because it may lead to ...?
The high blood pressure associated with pre-eclamptic toxaemia (PET) or toxaemia of pregnancy is frequently associated with PLACENTAL ABRUPTION.
has to do with its effect on the placenta...
Give two examples of acceptable kick count procols?
6 kicks in one hour, 10 in 2 hours
What does a NST (non stress test) consist of?
continuous assessment of fetal heart rate using external doppler for 20 minutes
when is an NST (non stress test) NON-REASSURING?
NST is NON-reassuring If there is:
1. spontaneous decels
2. poor-absent beat to beat variability
variability and ...?
when is a non stress test reassuring (comment on baseline FHR, fetal movements, variability)?
NST is reassuring if there is:
1. baseline FHR 120-160
2. 2 accelerations of FH to 15 beats above the baseline HR, lasting 15 seconds each
3. the tracing displays beat to beat variablilty (5 beats above/below the baseline)
The contraction stress test has been largely replaced by the ...?
biophysical profile
Use U/S to do this test...
The contraction stress test may still be used to assess ability of the fetus to withstand labour as in which condition?
IUGR (intrauterine growth restriction)
a type of restriction...
How is a contraction stress test performed?
oxytocin infusion is used to result in 3 contractions in 10 minutes; repeated late decelerations indicative of fetal distress requiring immediate delivery
use a drug and depending on FHR, have to take immediate action or not
Between which weeks is the complete obstetrical scan (or anatomy scan) performed?
18-20 weeks
BPP may be scored out of 10 if a ___ test is included?
NST (non stess test)
4 components studied in the BPP are...?
Gross body movements, Fetal tone, breathing movements, amniotic fluid index
what is a 'good' amniotic fluid index?
single pocket of 2cm x 2cm adequate for BPP
In the BPP, how many gross body movements should be seen in 30 minutes?
3 gross body movements in 30 minutes
How long is a BPP (ie. within what time duration must the various criteria be met)?
BPP is 30 minutes long
What kind of fetal tone observation would yield a 2 in a BPP?
one episode of active extension with return to flexion of limb or trunk (hand opening and closing also acceptable)
What kind of breathing movements would be assessed as 'good' in BPP?
one 30 second episode of fetal breathing movements (fetal diaphragm or kidneys seen to move up and down, chest wall in and out)
How is the AFI (amniotic fluid index) calculated?
By drawing imaginary perpendicular lines through the woman's umbilicius and adding up the maximum vertical pocket in each quadrant (5-25 cms is considered normal but normal AFI varies with gestation and curves exist to better judge increased or decreased fluid.
Established vessels in doppler flow studies include the ___ artery and the ___ artery?
umbilical artery (UA) and the Middle Cerebral Artery (MCA)
What is the prevalence of amenorrhea not due to pregnancy, lactation or menopause?
3-4%
less than 10%...
What is primary amenorrhea?
Absence of SVB (spontaneous vaginal bleeding) by 14 yo in girls without other signs of secondary sexual development. In the presence of otherwise normal development of breasts and pubic hair, primary amenorrhea is diagnosed only at age of 16 yo.
different for 2 ages depending on the presence or absence of secondary sexual characteristics/normal development...
In the presence of otherwise normal development of breasts and pubic hair, primary amenorrhea is diagnosed only at ___ years of age?
16 years of age
What is secondary amenorrhea?
defined clinically as the absence of menstruation for at least 6 months in a woman with previously normal and regular menses. For women with prior oligomenorrhea, the diagnosis necessitates up to 12 months without menstrual blood flow or at least 6 cycle times.
What is oligomenorrhea?
light or infrequent menstruation (menstrual periods that occur at intervals greater than 35 days and only occur 4 - 9 times per year). Often included in this definition is that women had regular cycles before.